The problem with peanuts

In August, 13-year-old Natalie Giorgi inadvertently bit into a peanut-butter treat at a Northern California summer camp, had a severe allergic reaction and died.

It is the kind of awful story that brings just about any parent to tears.

But for Shannon Bieger of Irvine, the story held a particular horror.

“I avoid those stories because they terrify me,” Bieger said, explaining that it took her weeks to finally read one of the links she had been seeing on Facebook.

Bieger's daughter Kyla, 8, was diagnosed with a peanut allergy as a toddler.

Kyla, says her mom, is the “foodie child” in the family: “She loves to eat everything.”

When Kyla was 16 months, her aunt brought over some peanuts. Kyla got hold of some and started sneezing, her eyes became puffy and then she began vomiting.

It was an allergic reaction, called anaphylaxis, in which Kyla's immune system basically went berserk, her white blood cells indiscriminately releasing agents intended to kill germs, but instead affecting her own body tissues.

An allergic reaction is treated with an injection of epinephrine (adrenalin). About a third of the reactions require more than one injection to control.

Kyla's initial reaction did not, however, become life-threatening.

Testing showed that Kyla is allergic to peanuts. Peanuts are not related to tree nuts (walnuts, pecans, almonds, etc.) but are legumes. Kyla is also allergic to legumes such as peas and lentils.

Kyla is hardly alone. Researchers have noted a startling rise in peanut allergies among children in the past decade, says Dr. Elizabeth Yanni, a pediatrician and internist with the Hoag Medical Group.

“One county in Minnesota – Olmstead County – saw rates triple in 10 years,” Yanni said, adding that this example represents the top end of what has been reported, and the other research has shown less-dramatic increases in the populations studied.

The reason for the increase remains an open question, Yanni says: “Nobody really knows. There are multiple theories.”

One is the “hygiene theory” – the immune system doesn't have germs and other invaders to fight, so it turns on the next tier of foreign substances: food.

Then there's the “timing theory:” Some studies have shown a correlation between early introduction of certain foods to infants' diets and subsequent allergies to those foods.

“But they're just theories,” Yanni cautions. “Nobody has been able to prove anything.”

But the reasons don't matter much to the growing number of affected families, or to the schools, churches and other institutions that have groups of children under their care.

Shelly Holcomb's son Joshua, 3, has a peanut allergy and, she says, “we don't have peanuts or (peanut) products in the house. … I have to read packages all the time. ‘Made with equipment that is also used to process peanuts' – that's the warning.

“I'm Chinese, but we can't go to Asian restaurants because they cook with a lot of peanut oil. … Chick-fil-A, Five Guys, a lot of restaurants use peanut oil. You always have to check.”

Still, Holcomb said, her son's preschool is “very supportive” of accommodating Joshua and one of his schoolmate's allergies, watching to make sure that no food is shared and having a separate peanut-free area available.

The Newport-Mesa Unified School District has adopted a policy in line with many other districts, says Nutrition Services Director Dale Ellis: The only menu items district cafeterias serve that has peanuts as an ingredient is peanut butter and jelly sandwiches, and a sunflower butter and jelly sandwich is available as a substitute.

In addition, schools in the district have the option to set aside peanut-free tables or designate areas for peanut consumption. Two of the district's schools have exercised the first option, Ellis said, and one has a designated table for eating peanut products.

Yanni says she cautions parents against going too far to put their children in the spotlight for their allergies.

“It's warranted from the parents' side in trying to protect their child,” Yanni said, “but you have to consider that there are other difficulties … in social interaction. You don't want your child labeled.”

Measures like banning or restricting peanut products in the schools “may be met with strong resistance,” she says. “Anything you can't bring to school causes anger – and it ends up directed at the kid with the allergy.”

Bieger doesn't necessarily agree.

Talking about Kyla's school, she says peanut-free tables “are not ideal. Even the smell can trigger her. There have been times she's played on the bars and gotten a reaction from that. … Because peanut butter can get on everything and her reaction can be severe, I'd like to see schools be peanut-butter-free.”

“I don't know how realistic that is,” she adds.

And Bieger says she hasn't seen a backlash yet. Kyla's friends, she said, “are usually pretty mindful of it, and try to help.”

And in any event, Bieger says, “Kyla is a confident kid, so she's not really going to be affected by it.”

Either way, Kyla's allergy is a fact of life and “we just live with it.”

“She loves food, so it's kind of a bummer,” Bieger says ruefully. “You wish the picky one had it – she wouldn't mind never eating peanut butter again.”